How Is Addison's Disease Diagnosed?
Addison’s disease can present as an acute illness or come on gradually. With chronic Addison’s, the symptoms are vague and non-specific, and Addison's disease can be difficult to diagnose. Often, it's first detected through routine blood tests in a hospital or doctor's office to check for sodium, potassium and white blood cell levels. The doctor will also check for hyperpigmentation, or darkening, of the skin or gums -- a sign of long-term Addison's.
The most definitive way to diagnose the condition is to measure hormone levels in the blood and urine before and after giving ACTH. ACTH is a hormone in the brain that, when activated, normally increases the amount of cortisol being produced by the adrenal glands. Measuring ACTH levels can help distinguish whether Addison's disease is a caused by a problem in the adrenal gland or the brain.
What Are the Treatments for Addison's Disease?
Since Addison's disease is caused by a lack of normal hormones produced by the adrenal glands, it can be treated by replacing those hormones. This can be done with once- or twice-daily tablets of hydrocortisone, a steroid hormone. If needed, aldosterone can be replaced with a synthetic steroid, fludrocortisone acetate (brand name Florinef), which is taken orally once a day. These medications need to be increased during times of stress, infection, surgery, or injury.
Treatment is almost always completely successful. When treated, people with Addison's disease can lead a full and normal life. It is, however, important to carry a medic alert bracelet and emergency ID card at all times and to keep a small supply of medications at work or school. Even missing one dose can be dangerous.
In patients suspected of having an Addisonian crisis, doctor-prescribed injections of salt, fluids, and glucocorticoid hormones may be given immediately -- even before a diagnosis of Addison's disease is confirmed.